Application for or Request to Cancel Elective Coverage Have questions? Need assistance? BWC is here to help! Call 18006446292, and listen to the options to reach a customer service representative.

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How to fill out the OH U-3S (BWC-7613) online

This guide provides clear, step-by-step instructions on how to complete the OH U-3S (BWC-7613) form online. Whether you are a sole proprietor, a partner, or a minister, this document will help you navigate the process smoothly.

Follow the steps to complete the OH U-3S (BWC-7613) form successfully.

  1. Press the ‘Get Form’ button to access and open the form in your online document editor.
  2. Fill in the legal business name and policy number at the top of the form. Ensure that these details are accurate as they identify your business in the BWC records.
  3. Provide the trade name or 'doing business as' name, along with the mailing address, federal employer identification number or social security number, city, state, ZIP code, and telephone number.
  4. In Section A, list the owners or ministers who are electing coverage. For each individual, include their name, residential address, city, social security number, state, title, date of birth, and duties.
  5. If applicable, Section B allows you to request cancellation of elective coverage. Enter the name of the individual whose coverage is to be canceled and the effective date of cancellation.
  6. Sign and date the certification section. This confirms that the application is accurate and that you have the authority to execute it. Incomplete forms will not be processed.
  7. Once all sections are completed, you can save your changes. After saving, the form can be downloaded, printed, or shared as needed.

Complete your OH U-3S (BWC-7613) application online today for seamless processing.

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